Current incidence of the disease at a glance, recommendations and mandatory vaccination by country October 1, 2024

1. 10. 2024

Yellow fever

Bolivia

Since the end of April this year, 3 people have died and two others have become ill in the La Paz department. These are the first cases in the region in 3 years. 2 infections have been registered in the Santa Cruz department. Vaccination is recommended when traveling to the lowlands east of the Andes. Yellow fever vaccination is mandatory when entering from endemic areas.

West Nile fever

Germany

In mid-August, an infection was confirmed in a woman from Saxony when testing a blood donation sample. At the beginning of September, 2 more infections were reported, one each in Saxony and Berlin. In September, an infection was also detected for the first time in Lower Saxony when testing a blood donation sample. This year, the virus was detected in 42 birds and 54 horses. Most of the cases come from Berlin and Brandenburg. In 2018, the first locally acquired infections in Germany were registered in birds and horses, and in late summer 2019, 5 people fell ill in eastern Germany for the first time. In 2022, 17 infections were recorded in humans, and in 2023, there were 7. The virus mainly infects birds, but can also spread to humans, horses and other mammals. Be careful of mosquitoes.

West Nile fever

Greece

Since the beginning of July this year, 189 cases have been registered in several regions. 17 people have died. The infection occurs sporadically in Greece, especially in the northern regions. Be careful of mosquitoes.

West Nile fever

Italy

Since the beginning of July, 287 infections and 10 deaths have been reported, affecting the regions of Lombardy, Emilia-Romagna, Veneto, Friuli-Venezia Giulia and Apulia. The infection occurs sporadically in Italy, especially in the northern regions. Be careful of mosquitoes.

Dengue

Spain

At the beginning of September, 5 locally acquired infections were registered in the province of Tarragona (Catalonia). These are the first this year. Be careful of the predominantly diurnal carrier mosquitoes. A vaccination has been available since February 2023.

Dengue

USA

In the state of Florida, 37 local infections were reported by mid-September this year. The counties affected are Miami-Dade, Monroe, Hillsborough, Orange, Pasco, Manatee and Palm Beach. Health authorities in Los Angeles County (California) have recorded three local infections since the beginning of September. Be careful of the predominantly diurnal carrier mosquitoes. A vaccination has been available since February 2023.

Intestinal infections

Egypt

Risk of diarrhea nationwide. In recent years, there have been repeated cases of infections with enterohemorrhagic Escherichia coli (EHEC) in returning travelers, especially from Hurghada. Hepatitis A is also very common. Raw salads and insufficiently cooked food should be avoided. Tap water should not be drunk. Pay attention to food hygiene and vaccinations.

Safety note

Egypt

Travel to the north of the Sinai Peninsula, the Egyptian-Israeli border area (with the exception of Taba) and remote areas of the Sahara is warned against. Unaccompanied, individual excursions and overland trips in the south of the Sinai Peninsula are not recommended (www.auswaertiges-amt.de).

Dengue

Australia

Since the beginning of this year, 1,640 cases have been reported nationwide. The states of Western Australia, New South Wales and Victoria are once again particularly affected. Pay attention to protection against day-active mosquitoes. A vaccination has been available since February 2023.

Pertussis

Australia

By the beginning of September, around 23,935 cases had already been reported nationwide, most of them in the states of Queensland and New South Wales. These are the highest number of cases since 2016. Last year, a total of around 2,440 cases were recorded nationwide. Before staying abroad, standard vaccinations should always be checked and supplemented if necessary.

Ross River fever

Australia

Around 3,100 cases were reported nationwide this year. The state of Queensland is particularly affected. Pay attention to mosquito protection.

Chikungunya

Brazil

This year, around 386,300 suspected cases and 170 deaths were reported. In the state of Minas Gerais, the authorities declared a health emergency at the end of January this year due to the epidemiological situation. Last year, around 256,930 suspected cases were registered nationwide, and around 146,250 infections were confirmed. 106 people died. Compared to the same period last year, the number of cases has increased significantly. In 2022, a total of around 265,300 suspected cases were reported. 75 people died. In mid-2014, health authorities reported the first local infections. Since then, the infection has spread nationwide. Be sure to protect yourself from mosquitoes.

Dengue

Brazil

There is a high risk of dengue throughout the country. Since the beginning of this year, around 9,569,470 suspected cases and 5,303 confirmed deaths have been registered nationwide. Compared to the same period last year, the number of cases has more than tripled. The authorities in 7 of the 27 states (Acre, Goiás, Minas Gerais, Espírito Santo, Rio de Janeiro, Santa Catarina and the Federal District) have declared a health emergency due to the epidemiological situation. Last year, around 3,028,600 suspected cases were registered nationwide and 1,094 people died. In 2022, around 2,363,500 cases of illness and around 930 deaths were recorded. Be sure to protect yourself from mosquitoes that are mainly active during the day. A vaccination has been available since February 2023.

Yellow fever

Brazil

This year, 3 infections have been confirmed in humans. One case of illness and one death have been reported in the state of São Paulo, and one person has died in the state of Amazonas. Vaccination is recommended for stays in Brazil.

Oropouche fever

Brazil

Since the beginning of this year, around 3,230 infections have been confirmed in the state of Amazonas. At the end of February, one case of illness was reported in the city of Rio de Janeiro. Since the beginning of February, further cases have been reported in the states of Rondonia, Acre, Para, Roraima and Tocantins. Outside the Amazon region, the following states are affected: Bahia, Espírito Santo, Santa Catarina, Minas Gerais, Mato Grosso, Mato Grosso do Sul, Sao Paulo, Rio de Janeiro, Piaui, Pernambuco, Ceará and Maranhao. In March, a 24-year-old woman died in the state of Bahia. Nationwide, the number of cases has risen to around 7,930, 2 people have died. The virus is transmitted by midges and predominantly nocturnal mosquitoes. The disease leads to an acute febrile syndrome including joint and limb pain and vomiting. Observe mosquito protection.

Intestinal infections

Dominican Republic

Risk of diarrhea nationwide. The Dominican Republic is one of the holiday destinations with the highest number of cases of travel diarrhea. Since October 2022, around 110 cholera infections have been reported. One person has died. The majority were registered in the capital, Santo Domingo. Pay attention to hygiene, consider vaccination if necessary.

Dengue

Dominican Republic

Since the beginning of this year, around 9,150 cases have been registered. 9 people have died. Last year, around 25,470 suspected cases were registered. 23 people have died. In 2022, around 10,440 suspected cases were reported. 42 people have died. The number of cases has roughly tripled in 2022 compared to the previous year. The municipalities of Santiago, Santo Domingo de Guzmán, Santo Domingo Norte, Santo Domingo Este and San José de Ocoa were particularly affected. In 2021, around 3,750 infections and 26 deaths were registered. Be careful of mosquito protection. A vaccination has been available since February 2023.

Entry requirements

Dominican Republic

The Dominican government has completely sealed the border with Haiti since September 15, 2023 until further notice. Travel by land, air or sea between the two countries is currently not possible (www.auswaertiges-amt.de).

West Nile fever

Greece

Since the beginning of July this year, 189 cases have been registered in several regions. 17 people have died. The infection occurs sporadically in Greece, especially in the northern regions. Be careful of mosquito protection.

Chandipura virus (CHPV)

India

Since the beginning of June this year, health authorities in the states of Gujarat, Madhya Pradesh, Rajasthan and Maharashtra have registered an increase in cases of encephalitis (Acute Encephalitis Syndrome, AES). In the state of Gujarat, 61 infections with the Chandipura virus (CHPV) have been confirmed since the beginning of June. 3 more confirmed cases come from the state of Rajasthan. The virus is transmitted by mosquitoes and sand flies.

Intestinal infections

India

Risk of diarrheal diseases nationwide. Cholera is to be expected regionally. Typhoid, paratyphoid and the orally transmitted forms of hepatitis are endemic throughout India. Anthrax occurs repeatedly in both the cutaneous and intestinal form among locals. Pay attention to hygiene and vaccination protection.

Dengue

India

Around 32,100 cases were registered nationwide by the end of June this year. 32 people have died. The states of Kerala, Karnataka and Tamil Nadu are particularly affected. Last year, around 234,430 cases and 91 deaths were reported. In 2022, around 233,250 infections and 303 deaths were recorded. Pay attention to protection against day-active vector mosquitoes (Aedes species). A vaccination has been available since February 2023.

Japanese encephalitis

India

According to press reports, around 425 people have fallen ill and 32 have died in the state of Assam (NO) since the beginning of April. In the first 8 months of this year, around 790 cases of Japanese encephalitis (JE) were registered nationwide. 60 people have died. Most infections were again registered in the state of Assam (NO). In 2023, 1,097 cases and 56 deaths were officially reported nationwide. Carry out exposure prophylaxis and possibly vaccination!

Malaria

India

Since January of this year, around 113,720 cases have been reported nationwide. 22 people have died. Most infections come from the states of Chhattisgarh and Jharkhand. Last year, around 223,960 cases were registered and 72 people died. Very good mosquito protection should always be observed, it is usually advisable to take emergency medication with you and, depending on the outbreak, chemoprophylaxis should also be discussed.

Safety advice

India

Travel to Jammu and Kashmir and Manipur is currently strongly discouraged. Demonstrations and large gatherings of people should generally be avoided and the instructions of the security forces should be followed. In addition, current media reports should be followed during a stay (www.auswaertiges-amt.de).

Rabies

India

In the state of Tamil Nadu, 22 people have died of rabies this year. In March of this year, one case of the disease and 3 deaths were reported in the state of Manipur (NE). Last year, deaths were reported in several states. In September 2023, the first death since 2017 was reported in the state of Goa. India is one of the countries with the highest number of cases in animals and humans worldwide. A total of around 310 people died in 2022. The main carrier is the (stray) dog. The big cities are also affected. If you have suspicious contact with animals, see a doctor immediately and make sure that modern tissue culture vaccines are used. A preventive vaccination is recommended for all travelers.

Zika virus

India

Since June this year, 100 infections and 5 deaths have been confirmed in the city of Pune (state of Maharashtra, W). The virus is found in large parts of the country. Be careful with mosquito protection.

Intestinal infections

Indonesia

Risk of diarrhea nationwide. Cholera outbreaks are reported sporadically from West Papua, and typhoid is to be expected. Continue to observe hygiene and vaccination against typhoid.

Dengue

Indonesia

The number of cases has risen sharply compared to the previous year. By the beginning of May, around 322,275 infections and 455 deaths had been reported nationwide. The health authorities in the province of Bali have warned tourists of an increase in the number of cases and, according to press reports, they and locals are being recommended to get vaccinated. Be sure to protect yourself from the predominantly diurnal carrier mosquitoes. A vaccination has been available since February 2023.

Entry requirements

Indonesia

Due to the increasing number of monkeypox cases worldwide, the authorities have adjusted the entry requirements. Since August 29, 2024, travelers must fill out the electronic health questionnaire at the Ministry of Health (https://sshp.kemkes.go.id/) before entering the country (departure) and receive a QR code that must be presented at check-in and upon entry.

Poliomyelitis

Indonesia

This year, 7 infections with vaccine-derived poliovirus type 2 (cVDPV2) were reported. Last year, a total of 6 infections with infections were confirmed on the islands of Sumatra and Java. A child had already fallen ill on the island of Sumatra in November 2022. This is the first case of polio detected in the country since 2019. The emergence of VDPV makes the country a country with a potential risk of the pathogen spreading internationally. As a result, all people (locals and tourists) who have stayed in the country for more than 4 weeks should be able to show that they have been vaccinated against polio when they leave the country. The vaccination must take place between 4 weeks and one year before departure and must be documented in an internationally valid vaccination certificate.

Safety note

Indonesia

Non-essential travel to five of the six provinces of the Indonesian part of the island of New Guinea (Papua, Papua Barat, Papua Pegunungan, Papua Tengah and Papua Selatan) is not recommended. Large crowds should generally be avoided and the instructions of the security forces should be followed. In addition, current media reports should be followed during a stay (www.auswaertiges-amt.de).

Dengue

Maldives

The number of new infections has risen sharply since the end of March this year, and by the end of July around 2,675 people had fallen ill. The number of cases is now significantly higher than the comparable figures for the last 2 years. A total of around 3,420 cases were reported in 2023. Take precautions against the predominantly daytime carrier mosquitoes. A vaccination has been available since February 2023.

Safety notice

Austria

The flood situation caused by extreme rainfall is gradually easing. There are still major traffic disruptions, especially in Lower Austria. Prohibitions, signs and warnings as well as the instructions of the Austrian authorities should be followed and the regional weather and traffic information observed (www.auswaertiges-amt.de).

West Nile fever

Austria

33 cases have been reported since the end of July this year. The area around Vienna, northern Burgenland and the Weinviertel are affected. The infection occurs sporadically in Austria. The virus is transmitted from one host to the next by mosquitoes. It mainly infects birds, but can also spread to humans, horses and other mammals. Take precautions against mosquitoes.

Ticks

Austria

During the warm season there is a risk of tick-borne diseases, in large parts of the country also of TBE, which can lead to encephalitis. Be careful to protect yourself against tick bites. If you are staying in an infected area, vaccination may be recommended after an individual risk assessment.

Dengue

Spain

At the beginning of September, 5 locally acquired infections were registered in the province of Tarragona (Catalonia). These are the first this year. Be careful to protect yourself against the predominantly diurnal carrier mosquitoes. A vaccination has been available since February 2023.

Crimean-Congo hemorrhagic fever

Spain

This year, one infection was acquired in the province of Salamanca (Castile and León region) and one in the province of Toledo (Castile-La Mancha region). Between 2013 and 2022, a total of 12 infections were reported, and 4 patients died. The regions of Castile and León and Extremadura in the northwest of the country are affected. The pathogen is usually transmitted by ticks, but occasionally from person to person. Exposure prophylaxis (e.g. repellents, covering clothing) and early tick removal are recommended.

West Nile fever

Spain

This year, 24 infections were reported in the Andalusia region, most of them in the province of Seville. 7 infections were recorded in the Extremadura region. The virus is transmitted from one host to the next by mosquitoes. It mainly infects birds, but can also spread to humans, horses and other mammals. Be sure to use mosquito repellent.

Safety notice

South Africa

Given the significant social differences in the country and not least due to the worsening electricity supply crisis, protests and demonstrations may occur. Violent clashes and traffic disruptions cannot be ruled out. For example, there have already been repeated violent actions in the Emalahleni area (on the main connecting road between Johannesburg and tourist destinations in the east of the country, such as the Blyde River Canyon and the Kruger National Park). The electricity crisis with frequent and prolonged power cuts continues. These lead to temporary power outages, including in private accommodation, shops, banks and ATMs, public lighting, traffic lights and security systems. The power outages can also affect the water supply and quality and continue to lead to restrictions in internet connections and mobile communications. Gas stations can also be temporarily affected. For safety reasons, the Western Cape government’s tourism security unit recommends that travelers do not hike alone and only in groups. There have recently been several robberies of tourists, particularly on the hiking trails around Table Mountain (Devil’s Peak, Lion’s Head and Signal Hill) in Cape Town. For safety reasons, the South African National Parks Authority recommends that travelers refrain from using the so-called Numbi Gate when entering the Kruger National Park and use alternative entrance gates. It is recommended that travelers avoid using the R335 via Motherwell to get to Addo Elephant Park from Port Elizabeth (Gqeberha) and instead use the N2 via Colchester. Demonstrations and large gatherings of people should generally be avoided and the instructions of the security forces followed. In addition, current media reports should be followed during a stay (www.auswaertiges-amt.de).

Rabies

South Africa

Since the beginning of this year, 3 deaths have been registered. Last year, 11 cases were confirmed in humans, and in 2022 there were 13. The provinces of Limpopo, KwaZulu-Natal and Eastern Cape were particularly affected. A sharp increase in rabid dogs has been observed nationwide since 2022. Rabies occurs in animals nationwide, affecting jackals, mongooses, cows, unvaccinated dogs and cats, among others. At the beginning of June, an infection in a South African fur seal (Arctocephalus pusillus) was confirmed for the first time in Cape Town. By the end of July, 14 more cases had been registered. According to the Cape Town City Council, 8 people have now also been bitten, all of whom have been asked to seek treatment. The population should keep themselves and their dogs away from the seals in the entire coastal region of the Cape Peninsula. The most common source of infection for humans is dog bites. If there is contact with such animals, seek medical attention immediately; preventive vaccination is recommended if there is a foreseeable risk and the stay is longer.

Intestinal infections

Tanzania

Risk of diarrheal diseases nationwide. Localized outbreaks of cholera occur regularly. There have been outbreaks in 21 regions since September last year. Pay careful attention to hygiene, and consider vaccination if necessary.

Entry requirements

Tanzania

With effect from October 1, 2024, all visitors to Zanzibar (except residents with Tanzanian residency permits) must take out mandatory entry insurance from the Zanzibar Insurance Corporation (ZIC) for the duration of their stay (up to 92 days). This insurance can only be taken out with the ZIC. Other international travel insurance policies are not accepted. The policies can be purchased from September 1, 2024. The current cost is USD 44 per person. Further information is available on the Visit Zanzibar website (https://visitzanzibar.go.tz/). Entry may be refused if the correct insurance is not proven.

Entry vaccination requirements

Tanzania

The risk of infection with yellow fever in Tanzania is classified by the WHO as low, and vaccination is not generally recommended. According to the official entry vaccination requirements (ITH 2020), a yellow fever vaccination is required for people over 1 year of age when entering from endemic areas. Experience has shown that the regulations change frequently and the information provided by the various authorities differs from one another. The regulations are sometimes interpreted and handled differently at some airports (Kilimanjaro Airport in Arusha) or by individual border officials. Contrary to the official information, a yellow fever vaccination is often required when entering Zanzibar. An official statement from the Zanzibar Ministry of Health is published on the website of the Federal Foreign Office.

Malaria

Tanzania

After the disease was considered almost eliminated on the Zanzibar and Pemba island group for many years, the number of cases has been increasing again for several years. Since October last year, the number of cases in Zanzibar has risen sharply. Very good mosquito protection should always be observed, and chemoprophylaxis is also recommended.

Poliomyelitis

Tanzania

In July last year, the first infection with vaccine-derived poliovirus type 2 (cVDPV2) was reported. At the beginning of September and at the end of December, another infection was reported. Due to the emergence of cVDPV2, the country is formally one of the countries with a potential risk of the pathogen spreading internationally. As a result, all people (locals and tourists) who have stayed in the country for more than 4 weeks must show proof of polio vaccination when leaving the country. The vaccination must take place between 4 weeks and one year before departure and be documented in an internationally valid vaccination certificate. Pay attention to vaccination protection.

Safety note

Tanzania

Unnecessary travel to the southern part of the Mtwara region (immediate border region with Mozambique) is not recommended (www.auswaertiges-amt.de).

Intestinal infections

Thailand

Risk of diarrheal diseases nationwide, and small outbreaks of cholera are also to be expected locally. Pay attention to hygiene.

Dengue

Thailand

Since the beginning of this year, around 68,330 cases and 51 deaths have been registered. Last year, around 159,220 infections and 179 deaths were reported. The provinces of Trat, Nan, Chanthaburi, Rayong and Mae Hong Son, as well as the capital Bangkok, were particularly affected. Pay attention to protection against diurnal mosquitoes. A vaccination has been available since February 2023.

Dengue

USA

In the state of Florida, 37 local infections were reported by mid-September this year. The counties affected are Miami-Dade, Monroe, Hillsborough, Orange, Pasco, Manatee and Palm Beach. Health authorities in Los Angeles County (California) have recorded three local infections since the beginning of September. Be careful to protect yourself from mosquitoes that are mainly active during the day. A vaccination has been available since February 2023.

Pertussis

USA

This year, around 15,700 cases were reported by mid-September, which is around five times as many as in the same period last year. Before staying abroad, standard vaccinations should always be checked and supplemented if necessary.

Sun protection

USA

Since the beginning of 2021, the sale of so-called reef-toxic sunscreens has been banned in the state of Hawaii, including products containing oxybenzone (BP3) and octinoxate. These substances are suspected of having a harmful effect on corals and other marine life.

West Nile fever

USA

By mid-September this year, around 660 infections had been registered. Most infections come from the states of Texas, California, Mississippi and Nebraska. The peak of the season is from July to October, but transmission is possible all year round. Be careful of mosquito protection.

Intestinal infections

Vietnam

Risk of diarrheal diseases nationwide, cholera is also endemic. Be careful of food and drinking water hygiene.

Dengue

Vietnam

Since the beginning of this year, around 57,860 cases of illness and 9 deaths have been registered nationwide. Last year, around 166,620 infections and 42 deaths were reported. In 2022, around 367,730 cases of illness and 140 deaths were registered. The number of cases was around 5 times higher than in 2021. Be careful of mosquitoes that are mainly active during the day. A vaccination has been available since February 2023.

Rabies

Vietnam

Since the beginning of this year, 60 deaths have been reported. Last year, a total of 82 people died of rabies infection. If you have suspicious contact with animals, you should see a doctor immediately. Preventive vaccination is strongly recommended, especially if there is a foreseeable risk and for longer stays. Consultation with a doctor experienced in travel medicine should be carried out well in advance of the trip.

Bird flu

Vietnam

In March of this year, an infection with influenza A(H9N2) was reported for the first time in Vietnam. In March of this year, a 21-year-old student fell ill with influenza A(H5N1) and subsequently died. He had previously caught wild birds. After a break of more than 8 years, a 5-year-old girl became ill with an influenza virus H5 in October 2022. She had eaten meat from sick chickens and ducks. Between 2003 and 2014, a total of 128 people nationwide fell ill with influenza A(H5N1), and there were 65 deaths. All of those affected had evidence of contact with animals. Since 2014, numerous outbreaks have been registered in domestic poultry across the country, and more than 129,000 animals have been killed. At the end of May last year, there was an outbreak in Quang Ngai province with around 1,700 sick ducks. Vaccination of poultry is widespread in the country. Since 2014, outbreaks of influenza A(H5N6) have been reported repeatedly in poultry farms. Since the beginning of 2021, 3 outbreaks have already been reported in 2 provinces. There have been no human cases of illness to date.